ABSTRACT

Objective To evaluate the niacin skin flushing response in adolescents with schizophrenia spectrum disorders (SSD), assess its diagnostic value, and explore its association with clinical symptoms.
Methods 58 adolescents (ages 10-19) with SSD and 80 healthy controls were enrolled. Niacin skin flushing was measured using a multi-concentration patch test system. Group differences were analyzed using generalized linear mixed models. The diagnostic efficacy was assessed with a LASSO regression model, and sparse canonical correlation analysis explored its associations with clinical symptoms.
Results Attenuated niacin skin flushing responses were found at 60, 20, and 6.67 mM concentrations in the adolescent SSD group (PFDR < 0.05). The LASSO model achieved an AUC of 0.86 (95% CI: 0.73-0.96). Sparse canonical correlation analysis revealed a significant pattern (r = 0.557, PFDR = 0.039): attenuated niacin skin flushing response was correlated with more prominent non-suicidal self-injury (load = -0.531) and manic symptoms (load = -0.292), while correlated with lighter psychotic symptom severity (load = 0.703) and anxiety (load = 0.317).
Conclusion   Attenuation of the skin niacin flushing response may serve as an early adjunctive diagnostic marker for adolescent SSD. The reduced niacin flushing response is associated with psychotic symptoms, mania, self-injurious behaviors, and anxiety, and may provide valuable insights for evaluating the clinical status of adolescents with SSD.

Key words: Adolescent；Schizophrenia spectrum disorder；Niacin skin flushing response; Sparse canonical correlation analysis